Individual
MR. CRAIG F WATHEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4728 E 98TH AVE, TAMPA, FL 33617-4512
(813) 454-2808
Mailing address
4728 E 98TH AVE, TAMPA, FL 33617-4512
(813) 454-2808
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA71333
FL
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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